Cellular iron metabolism in health and disease

Association of iron with colorectal cancer

Many studies indicate that animals and humans burdened with excess iron are at increased risk of neoplasia at various sites. This review focuses on inquiries that involve iron and colorectal cancer. Relevant studies reported in the past decade are briefly described and evaluated. The studies in animal models and in relatively large groups of humans point to a positive association of excessive iron with colorectal oncogenesis. Phytic acid, a chelator of iron and zinc, may be useful in withholding iron from the carcinogenic process. Sufficient evidence is available to justify construction of long-term prospective studies in humans in which would be monitored (i) levels of iron and phytate intake, (ii) serum transferrin iron saturation and ferritin, (iii) fecal levels of iron and hydroxyl radicals, and (iv) appearance of colorectal polyps, adenomas and carcinomas.

Iron chelators as therapeutic agents against Pneumocystis carinii

Iron plays a critical role in host-parasite interactions, and iron chelators have been demonstrated to serve as effective adjunct therapeutic agents against malaria. The effects of the parenteral iron chelator deferoxamine (DFO) on the growth of rat-derived Pneumocystis carinii were studied in a human fibroblast cell culture model and in two in vivo models of experimental infection. In addition, the effects of the investigational oral iron chelator CP20 and its 3-hydroxypyridin-4-one analogs CP51, CP94, and CP96 on the growth of P. carinii in vitro were assessed. DFO suppressed the growth of P. carinii in vitro in a dose-dependent manner, and daily injections of DFO markedly reduced the intensity of P. carinii infection in both mice and rats. Cell cultures treated with iron chelators that are administered orally to humans also showed substantial P. carinii growth inhibition. Reduction of P. carinii numbers after iron chelator therapy correlated with alterations in P. carinii morphology, as viewed by transmission electron microscopy. Since the use of current anti-P. carinii drugs is limited by toxicity or incomplete efficacy, or both, the role of iron chelation as adjunctive anti-P. carinii chemotherapy merits additional investigation.

Liver iron concentrations in sudden infant death syndrome

To determine the biological significance of high concentrations of non-haem iron in the livers of infants dying from sudden infant death syndrome (SIDS), liver samples were obtained at necropsy from 66 infants who died from SIDS and 28 control infants who died before 2.5 years of age. All were full term deliveries. Liver iron concentrations decreased rapidly with age in the two groups. Liver iron concentrations in the SIDS infants and controls were compared for those infants who died between 1 month and 1 year of age. The median liver iron concentration in the SIDS infants was 296 micrograms/g wet weight; significantly higher than the median of 105 micrograms/g in controls. There was an inverse relation between iron concentration and age in the two groups, but an analysis of covariance confirmed the significantly lower values in controls. The frequency (22%) of HLA-A3 in SIDS infants was similar to that expected for the United Kingdom population (25%) and does not implicate the gene for haemochromatosis as a cause of high liver iron concentrations. These findings show that the peak incidence of SIDS occurs when mean concentrations of iron in liver tissue are higher than at any other time of life. Although a primary causal connection seems unlikely, high tissue iron concentrations may lower resistance to infection and enhance free radical formation, leading to tissue damage.

Characteristics of an oxidant formed during iron (II) autoxidation

When ethanol (100 mM) and the spin trapping agent DMPO were added to a solution of FeSO4 (0.1 mM) in phosphate buffer (40 mM), pH 7.4, the spectrum of the 1-hydroxyethyl radical spin adduct of DMPO could be detected by ESR spectroscopy. The ESR signal intensity of the 1-hydroxyethyl radical increased with higher concentrations of phosphate. Under these conditions, hydroxyl radical adducts could not be detected. However, if H2O2 (0.1 mM) was also added, the ESR spectra contained signals from both the hydroxyl and 1-hydroxyethyl radical adducts of DMPO. When ethanol was replaced with azide (100 mM) in these experiments, strong ESR signals from the azidyl radical adduct of DMPO were observed only in the Fenton system. The absence of hydroxyl radical adduct signals in the Fe(2+)-PO4 reaction could not be explained by instability of the hydroxyl radical adduct in the presence of Fe2+ or superoxide. Experiments with oxygen radical scavengers indicated that the oxidant formed during Fe2+ autoxidation was less reactive to benzoate, DMSO and tert-butanol than the hydroxyl radical. The available data indicate that the primary oxidant formed during Fe2+ autoxidation in phosphate buffer is not the hydroxyl radical, but may be an iron-oxygen complex such as a ferryl species.

The effect of iron nutritional status on Trypanosoma cruzi infection in germfree and conventional mice

1. Conventional (CV) and gnotobiotic (GN) female CFW mice were infected with the Y strain of Trypanosoma cruzi. 2. After infection, both CV and GN groups received injections of iron-dextran or desferrioxamine. Non-injected mice served as controls. 3. The parasitemia was more intense in iron-dextran-treated mice. 4. The iron levels in serum, liver, and spleen were: (a) not decreased by desferrioxamine and (b) increased by iron-dextran treatments. 5. An increase in leukocyte numbers was observed in all GN and CV groups after infection. 6. There was no difference in total iron binding capacity (TIBC) and iron saturation transferrin (IST) between GN and CV mice before infection. 7. In CV groups, after infection, TIBC was decreased whereas the levels of IST were increased; in GN the opposite occurred. 8. Trypanosome-specific IgG and IgM antibody levels were raised in the GN group but not in the CV group.

A siderophore production mutant of Bordetella bronchiseptica cannot use lactoferrin as an iron source

Bordetella bronchiseptica secreted a hydroxamate siderophore when grown in Fe-depleted medium. A Tn5lac insertion mutant of B. bronchiseptica, DBB22, did not produce this hydroxamate siderophore and was incapable of using lactoferrin as an Fe source. Our data suggest that B. bronchiseptica uses a siderophore for removal of Fe from lactoferrin and transferrin rather than relying upon a receptor for these host Fe-binding proteins.

The role of iron and iron binding proteins in lymphocyte physiology and pathology

Knowledge concerning the roles of iron and iron binding proteins in lymphocyte physiology and pathology has developed rapidly over the last few years. The genes for the major iron binding proteins have been cloned and sequenced and are now being studied with respect to transcriptional and posttranscriptional regulatory mechanisms. T cells, B cells, macrophages, and natural killer cells appear to differ from one another in the ways in which they synthesize and utilize iron binding proteins and in the amount of iron they take up and store. This suggests that differential modulation of iron-dependent metabolic functions is an intrinsic part of the distinctive physiology of each cellular component of the immune system and that the distribution of iron between those components is a carefully managed facet of the immune response. Since the immune response does not seem to be dramatically impaired by alterations in iron supplies that adversely affect other organs, it may well be that the cells of the immune system are especially adapted to have both high-priority access to iron when supply is low and high-level protection against iron-related toxicity when supply is in excess.

Cell death and lipid peroxidation in isolated hepatocytes incubated in the presence of hydrogen peroxide and iron salts

The incubation of isolated hepatocytes in the presence of glucose plus glucose oxidase, a H2O2-generating system, resulted in extensive loss of cell viability, as expressed by the release of lactate dehydrogenase (LDH). Disturbance of metabolic functions such as glycogen and protein synthesis was also caused by H2O2, but in no case was malondialdehyde (MDA)-like products detected. The lytic effect of H2O2 was significantly enhanced by incubating hepatocytes in the presence of iron salts. Under these conditions, MDA-like products were detected, but lipid peroxidation and cell injury did not correlate. Iron chelators modulated the cytotoxicity of H2O2 in different (and opposite) ways: when iron was complexed with ADP, increased cell lysis was observed compared to uncomplexed iron plus H2O2. Iron-DTPA, on the contrary, decreased such a lytic effect. The preincubation of hepatocytes with desferrioxamine mesylate (Desferal; a strong iron chelator) abolished the cytolytic effects produced by the association of iron salts and H2O2, as well as the membrane oxidative injury due to H2O2 alone, thus suggesting the existence of an intracellular source of iron. This kind of mechanism (metal chelation rather than radical scavenging) is supported by the absence of any protective effect by some free radical scavengers against the oxidative injury induced by the association iron H2O2. Nevertheless, the glycogenolytic effects observed in the presence of H2O2 were not modified by Desferal. In our opinion, the cytotoxicity of the association H2O2 plus iron salts involves at least two different and independent mechanisms.

Roles of iron in neoplasia. Promotion, prevention, and therapy

Research and clinical observations during the past six decades have shown that: 1. Iron promotes cancer cell growth; 2. Hosts attempt to withhold or withdraw iron from cancer cells; and 3. Iron is a factor in prevention and in therapy of neoplastic disease. Although normal and neoplastic cells have similar qualitative requirements for iron, the neoplastic cells have more flexibility in acquisition of the metal. Excessive iron levels in animals and humans are associated with enhanced neoplastic cell growth. In invaded hosts, cytokine-activated macrophages increase intracellular ferritin retention of the metal, scavenge iron in areas of tumor growth, and secrete reactive nitrogen intermediates to effect efflux of nonheme iron from tumor cells. Procedures associated with lowering host intake of excess iron can assist in prevention and in management of neoplastic disease. Chemical methods for prevention of iron assimilation by neoplastic cells are being developed in experimental and clinical protocols. The antineoplastic activity of a considerable variety of chemicals, as well as of radiation, is modulated by iron. The present article focuses on recent findings and suggests directions for further cancer-iron research.

Bleomycin-detectable iron in the plasma of premature and full-term neonates

The bleomycin assay measures non-transferrin-bound iron, able to catalyze free radical reactions, in human plasma. No bleomycin-detectable iron is present in plasma from healthy adults. However, plasma from 3/15 premature babies was positive in this assay. Plasma from 52 apparently-healthy term babies was analyzed and 11 were positive in the bleomycin assay. Hence not only some premature but also some full-term apparently-healthy babies may be at risk of severe oxidative damage.

Siderophore production and DNA hybridization groups of Aeromonas spp

A correlation between the genospecies (DNA-DNA hybridization group) and the type of siderophore produced by 118 isolates of the genus Aeromonas was established. Organisms in hybridization groups 1 through 5 (including 5A, 5B, and 5AB) and group 12 predominantly produced the siderophore amonabactin, while an enterobactinlike siderophore was prevalent in groups 8/10 and 9. The siderophore produced by strains in group 6 may be an as-yet-unidentified nonphenolate, nonhydroxamate compound, and group 7 isolates synthesized no siderophores. Determination of the indigeneous siderophore (or the absence of one) produced by an isolate of the genus Aeromonas may assist in identification of the organism's genetic species and may suggest the presence of certain virulence properties.

Iron depletion: a defense against intracellular infection and neoplasia

Macrophages and other host cells activated by interferon-gamma (IFN-gamma) can be induced to form a flavoprotein that converts L-arginine to nitric oxide+L-citrulline. Nitric oxide causes efflux of non-heme iron from neoplastic and infected host cells. In the absence of L-arginine, IFN-gamma-induced infected cells can lower their net uptake of iron. Cellular depletion of the metal via either mechanism suppresses DNA synthesis as well as the functioning of aerobic respiratory enzymes. Macrophage regulation of growth of other host cells during embryogenesis, immune responses, or immunosurveillance might involve iron depletion.

Transferrins and heme-compounds as iron sources for pathogenic bacteria

The low concentration of free iron in body fluids creates bacteriostatic conditions for many microorganisms and is therefore an important defense factor of the body against invading bacteria. Pathogenic bacteria have developed several mechanisms for acquiring iron from the host. Siderophore-mediated iron uptake involves the synthesis of low molecular weight iron chelators called siderophores which compete with the host iron-binding glycoproteins lactoferrin (LF) and transferrin (TF) for iron. Other ways to induce iron uptake, without the mediation of siderophores, are the possession of outer membrane protein receptors that actually recognize the complex of TF or LF with iron, resulting in the internalization of this metal, and the use of heme-compounds released into the circulation after lysis of erythrocytes. In this review, the nonsiderophore-mediated iron-uptake systems used by certain pathogenic bacteria are emphasized. The possible contribution of these iron-uptake systems to the virulence of pathogens is also discussed.

Oxygen radicals as key mediators in neurological disease: fact or fiction?

A free radical is any species capable of independent existence that contains one or more unpaired electrons. Free radicals and other reactive oxygen species are frequently proposed to be involved in the pathology of several neurological disorders. Criteria for establishing such involvement are presented. Development of new methods for measuring oxidative damage should enable elucidation of the precise role of reactive oxygen species in neurological disorders.

Iron, free radicals and cancer

Free radicals, intermediates in the tissue damage caused by radiation, are formed, inter alia, in interactions catalyzed by iron, which synergizes with radiation and some cytostatics (anthracyclins) in causing cell damage. Conversely, iron chelators can counteract cell damage. Similarly, antioxidants can slow atherogenesis, caused in part by oxidative stress and free radicals. Cell damage is also prevented by physiological defense systems like superoxide dismutase, against endogenous free radicals formed by granulocytes, monocytes, etc. Iron can thus induce free radicals which cause DNA double strand breaks and oncogene activation. This is suggested by four epidemiological studies suggesting a higher cancer risk in patients with larger iron stores than in those with small iron stores. In addition to its effect on carcinogenesis, iron can also maintain the growth of malignant cells as well as growth of pathogens. Breast cancer cells, for instance, display 5-15 times more transferrin receptors than normal breast tissue. Iron-carrying transferrin is in fact a growth factor. Hyposideremia in patients with cancer or infection is not a paraphenomenon but a functioning defense mechanism ('nutritional immunity'). If this immunity is broken by iron administration, relapses of diseases like tuberculosis, brucellosis, and malaria have been described. While iron-deficiency anemia should of course be diagnosed, treated and if possible prevented, there are good reasons to avoid over-utilization of medicamental iron.